Year-over-year increases in U.S. maternal mortality rates, particularly among people of color, underscore health disparities and the need for more funding and research into women’s health.
To address the nation’s systemic inequities in health care, the White House launched an initiative to understand how research in this field is conducted and funded.
To gain a more localized perspective, Public Good News spoke with the founder and CEO of a community-based women’s clinic dedicated to improving birth outcomes in Mississippi, where maternal mortality rates worsened between 2017 and 2019 and are among the highest in the United States.
Getty Israel
Lives in: Jackson, Mississippi
Profession: Founder and CEO
Affiliation: Sisters in Birth
Israel told us about the health care challenges Black women and those who can become pregnant encounter in Mississippi and her work to mitigate them.
[Editor’s note: This content has been edited for brevity and clarity.]
In the state of Mississippi and many other states, unfortunately, 51 percent of our counties are maternity deserts, where we have no OB doctors, or nurse midwives, or hospitals. So, women have to drive great distances to get to a doctor or have their babies at home. Some don’t make it.
If you really want to change birth disparities in places like Mississippi, you’ve got to change the health care infrastructure. We have to make a new lane for birth centers and midwives and put community health workers on the team.
Our greatest challenge in Mississippi is that we don’t have a system here—not private or public—that supports the work. Sisters in Birth has not been able to get any funding from any institutions in the state of Mississippi to do this work in this so-called pro-life state.
The Republican-controlled government here—which controls the executive branch, as well as the legislative branch—is stuck on abortion. That’s where all efforts and energy and resources have gone: toward so-called pregnancy crisis centers, whose whole focus is to make sure a woman doesn’t have an abortion. But those centers don’t provide the kinds of services that we provide to make sure she has a healthy baby.
There is no focus on prevention, on community health. Community health workers should be in every county so that women have access to them.
We’re barely in Hinds County, the largest county in the state, because we’re so underfunded.
The health care system, at least the one in Mississippi, does not welcome birth workers, community health workers. Doctors and hospitals don’t want people like my workers—and they told me this—interfering with labor and delivery.
Because they know that a well-informed patient is going to push back, she’s going to ask questions, she’s going to make demands, she’s going to make [providers] explain things. She’s going to say to him, “Is it medically necessary?” And if he can’t say that it is—whatever intervention he’s pushing at the time, and it’s usually an induction or C-section—he knows there’s the chance she’s gonna go somewhere else or just not show up for the intervention. Because that’s what a well-informed patient should look like. And that’s what a well-informed patient can do.
It seems to me [that] many doctors tend to want to do what is most convenient, expedient, and profitable for them. And that is usually to put a woman’s pregnancy and her labor on a schedule. They want to schedule it on a weekday, early in the morning. That’s not how babies were designed to come into this world.
There is no engagement around decision-making. Women are going in with their heads held down, their eyes on the floor, and being told what they’re going to do.
[They’re] not being asked, not being told, “Think about it,” not being told, “Read this,” like they don’t own their own bodies.
Building a birth center will give women whose pregnancies are low risk an alternative to our current health care system.
The first one will be built next year. And then I intend to replicate the model, because after we’ve done all this pre-labor work or pre-birth work we have to continue these relationships with women if we want to sustain this work.
You can do that in a birth center that offers clinical care, labor delivery, and community health services.